An online survey of UK women’s attitudes to having children, the age they want children and the effect of the COVID-19 pandemic

Abstract

STUDY QUESTION What are women’s views on having children, including the age they want to have them and other influences such as the coronavirus disease 2019 (COVID-19) pandemic? SUMMARY ANSWER Women’s views on having children, at their preferred age of 30 years, included their maternal urge and concerns about their biological clock and stability, while 19% said COVID-19 had affected their views. WHAT IS KNOWN ALREADY Women globally are delaying the birth of their first child, with the average age of first birth approaching 32 years in some countries. The average age women have their first child in the UK is 30.7 years and over 50% of women aged 30 years are childless. The fertility rate stands at 1.3 in several European Union countries. Some people are not having their desired family size or are childless by circumstance. It is essential to understand people’s attitudes to having children in different countries to identify trends so we can develop educational resources in an age-appropriate manner. STUDY DESIGN, SIZE, DURATION We conducted an anonymous, online survey of multiple choice and open-ended questions. The survey was live for 32 days from 15 May 2020 to 16 June 2020 and was promoted using social media. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 887 women from 44 countries participated in the survey. After filtering out women who did not consent, gave blank or incomplete responses, and those not in the UK, 411 responses remained. From the data, three areas of questioning were analysed: their views on having children, the ideal age they want to have children and the effects of the COVID-19 pandemic. Qualitative data were analysed by thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE The average age (±SD) of the women who completed the survey was 32.2 years (±5.9), and they were mainly heterosexual (90.8%) and 84.8% had a university education. One-third of women were married/in a civil partnership (37.7%) and 36.0% were cohabitating. In relation to their views on having children, the main themes identified were: the maternal urge, the ticking of the biological clock, why did no one teach us this?, the need for stability and balance in their life, pressure to start a family and considering other ways to have a family. When asked ‘In an ideal world, at what age approximately would you like to have had or have children?’ a normal distribution was observed with a mean age of 29.9 (±3.3) years. When asked ‘What factors have led you to decide on that particular age?’ the most frequent choice was ‘I am developing my career’. Three themes emerged from the qualitative question on why they chose that age: the need for stability and balance in their life, the importance of finding the right time and life experiences. The majority of women felt that the COVID-19 pandemic had not affected their decision to have children (72.3%), but 19.1% said it had. The qualitative comments showed they had concerns about instability in their life, such as finances and careers, and delays in fertility treatment. LIMITATIONS, REASONS FOR CAUTION The survey was promoted on social media only and the women who answered the survey were highly educated. WIDER IMPLICATIONS OF THE FINDINGS The women surveyed ideally want children at age 30 years but there are obstacles in their way, such as the need to develop their career. Global tailored fertility education is essential to ensure people make informed reproductive choices. In addition, it is essential for supportive working environments and affordable childcare to be in place in every country. STUDY FUNDING/COMPETING INTEREST(S) J.C.H. is founder of www.globalwomenconnected.com and Reproductive Health at Work, and author of the book Your Fertile Years. This project was funded by the Institute for Women’s Health, UCL. TRIAL REGISTRATION NUMBER N/A.

What have 16- to 18-year-olds in England learnt about reproductive health? A survey of school students

“…Other studies have found that there is an overestimation of the efficacy of assisted reproductive technologies (Hashiloni-Dolev et al, 2011; Lucas et al, 2015). A lack of understanding of basic reproductive health concepts has the potential to lead to people not fulfilling their family goals later in life (Harper et al, 2017; Harper and Botero-Meneses, 2022). These findings therefore emphasise the importance of topics being taught accurately by experienced teachers to enable students subsequently to make informed reproductive health choices.…”

“…The survey included a mixture of multiple-choice and open-ended questions asking about sex, reproductive health, fertility and reproduction. The questions were created following a review of the RSE curriculum for secondary schools in England and the equivalent curricula elsewhere in the UK (Department for Education, 2019; Maslowski et al, 2022Maslowski et al, , 2023 and from questions asked in a previous enquiry (Harper and Botero-Meneses, 2022).…”

Fear of fertility side effects is a major cause for COVID-19 vaccine hesitance in infertile patients

“…Decline of fertility over time and inferior outcome of an assisted reproductive technique (ART) treatment were serious concerns of women during the first wave of the pandemic when fertility clinics Here, an Italian study provided reassuring data and found no impact of postponement of treatment during the COVID-19 pandemic on reproductive outcomes of women utilizing fertility treatment (24). Nevertheless, pressure and anxiety about the "biological clock" was increasing in a United Kingdom study performed during the pandemic, and respondents stated that they still lacked education about general fertility decline with increasing age (25).…”